家庭医生签约制度国际特征及对我国的策略性启示

Insights of Family Physicians Service Models on the Institutional Strategy Developing in China

发达国家不同程度实现了基层首诊和有序就诊格局,签约或注册家庭医生为卫生服务常规序。以初级卫生保健作为基石,不同医疗照护体系下各国的家庭医生签约服务各自发展为具有典型特征的运行模式。其制度存在的共性特征为当前我国逐步构建并进一步落实家庭医生制度提供了有效的策略性启示。文章采用综述及对比分析方式,以构建我国家庭医生签约服务制度为出发点,对国际环境下家庭医生签约制度的共性特征进行梳理和总结。从政策制定与立法完善、筹资与补偿机制、全科医生薪酬体系以及全科医生培养和质量保障体系等制度化建设角度提出策略性建议。

It reviews and summarizes the key institutional features of the family medicine system in the developed countries by using a comparative narrative approach. Developed countries have commonly employed the referral system, and contracting or registering with a family doctor as the routine of health services. With primary health care as the cornerstone of the medical system, in the process of building and developing a general practitioner system developed countries shared the common characteristics. Systems and legislation confirming the establishment of a medical service system with a clear layout and a clear division of labor;national policy guarantees a stable investment in general practice;the free practice of family physician is a public contract-type medical service supply model;and a comprehensive quality assurance system for general practitioners.